Graduated: 2023
NPI: 1720765977
Practice Locations (2)
PARK NICOLLET CLINIC
5320 HYLAND GREENS DR
BLOOMINGTON, MN 554373934
9529932400
TRIA ORTHOPAEDIC CENTER LLC
8100 NORTHLAND DR
BLOOMINGTON, MN 554314800
9528318742
Source: CMS National Downloadable File, September 2026.